Promoting metacognition in an allied health anatomy course

Abstract

Metacognition, the ability to self‐regulate one's learning and performance, has been shown to improve student outcomes. Anatomy is recognized as one of the toughest courses in allied health curricula, and students could benefit from metacognitive activities. The purpose of this study was to explore the changes in metacognition of allied health students in an anatomy course and identify which groups need support with this skill. First‐year physician assistant (MPAS), physical therapy (DPT), and occupational therapy (OTD) students (n = 129) were invited to participate. At the beginning and end of the course, students completed a questionnaire including the metacognitive awareness inventory (MAI) that assesses metacognition. Students were also asked to reflect on their examination performances using a modified Likert scale and participated in reflective discussion boards to encourage development of metacognitive skills, which were thematically analyzed. Paired metacognition scores had increased significantly by the end of the course. However, middle‐performers anticipated high grades and were less satisfied with their grade, indicating a disconnect in their metacognition compared to high‐ and low‐performers. Students' receptiveness to modifying study strategies to improve performance declined throughout the course; by mid‐way through, they relied more on existing strategies. Increasing time constraints were frequently cited as a major factor when considering study strategies and modification of such strategies. To maximize the effectiveness of metacognitive activities, they should be positioned early in the course when students are most receptive. In addition, middle performers may benefit from additional support to improve metacognition.

Pre‐ and post‐examination reflections of first‐year medical students in an integrated medical anatomy course

“…Conversely, repeating students often committed to a particular study strategy until they received feedback in the form of their examination scores, and even then, the students opted to enhance the existing strategy rather than switching to something different. This "doubling down" on a familiar study strategy rather than exploring other potential strategies has been previously documented in allied health students (Cale et al, 2023). As stress and fatigue mounted, the allied health students preferred to rely on familiar but less effective strategies because they lacked the time to risk exploring new strategies.…”

“…This introduces the students to the practice of metacognitive reflection early in their education but limits our ability to determine if or how metacognitive ability and exam preparation strategies change over subsequent exams. Future iterations of the PBLI could be deployed after subsequent Human Structure exams to encourage students to continue the practice of metacognitive reflection as well as facilitate longitudinal data collection on student metacognition and exam preparation strategies.However, work completed by the authors has found that students are most receptive to changes in their learning strategies early on within a professional medical course, with little change occurring following subsequent exams, which supports the placement of the PBLI activity within this curriculum(Cale et al, 2023). More broadly, several other factors may have also contributed to a student's likelihood of struggling in Human Structure and medical school as a whole, such as an URiM background or a lack of laboratory-based anatomy experience.…”

“…Students who ultimately went on to repeat the course and students who fell into the “Fail” tier (<70%) on just the first exam often overestimated their abilities and predicted strong performances, whereas top‐performing students in the “Honors” tier (>92%) often underestimated their abilities and anticipated weaker performances. This mismatch between predicted and actual examination performance across all pass tiers suggests some degree of metacognitive disconnect, possibly related to a lack of declarative knowledge (Cale et al, 2023). Declarative knowledge, a key component of metacognition, is defined as knowledge of oneself as a learner and factors that may influence their performance, such as learning goals or assessment criteria (Lai, 2011).…”

Embedding patient safety in a scaffold of interprofessional education; a qualitative study with thematic analysis

“…Effective communication is integral for clinical reasoning involving critical questioning, interdisciplinary collaboration, and patient involvement [ 32 ]. Participants were cognizant of all these aspects; however, prompts by the facilitators were needed to improve the interprofessional discussions.…”

Creating evidence‐based engaging online learning resources in neuroanatomy

“…It is already well evidenced that students are not particularly good at regulating their own study behaviors, or time on task when combinations of resources are offered (Naumann, 2019). Therefore, it is the responsibility of educators to support them through hybrid teaching reforms by offering students effective metacognitive strategies on how to use and integrate their resources effectively with face‐to‐face components (McCabe, 2011; Cale et al., 2023). By developing digital tools where the cognitive demands are known (through the instructional design process), educators can make conscious decisions on aspects such as designing dual code over single code presentations or considering the impact of low interest versus high interest detail.…”